According to the American Cancer Society, approximately 1.3 million people are diagnosed with cancer each year, with the annual cost of treating cancer exceeding $60.9 billion. Mental health and psychosocial factors can be strongly associated with treatment adherence, treatment response, and quality of life among cancer patients. Too often, however, these aspects of the cancer experience are poorly recognized and under-treated. The Mental Health Assessment and Dynamic Referral for Oncology (MHADRO) will provide for an automated assessment and ongoing monitoring of mental health and psychosocial symptoms, such as depression, anxiety, and PTSD; cancer-related symptoms, such as pain and fatigue; quality of life; and adherence with treatment recommendations. The MHADRO's individualized summary reports will help oncology treatment providers to decide whether and how to intervene when clinically elevated mental health symptoms are present or when a patient reports a desire for treatment or support. Moreover, the dynamic referral capacity of the MHADRO will actually facilitate linkage with mental health treatment providers. Patients who choose the dynamic referral will have their summary report, a signed authorization to release information, and their personal contact information (e.g., telephone number, address) electronically transmitted to a credentialed mental health provider, who will then be responsible for contacting the patient to discuss treatment options. This process will utilize secure, HIPAA-compliant transmittal technologies. In addition, the MHADRO will allow mental health providers and community based psychosocial support (CBPS) programs to better target their services to those who need it most and to evaluate the effectiveness of their programs. Finally, hierarchical linear modeling techniques will be applied to longitudinal data (collected during Phase II) to establish predictive models for expected treatment response (ETR) to mental health interventions and for treatment non-adherence. This will allow the MHADRO to function as a "learning system." Phase I specific aims are: (1) Construct the patient assessment and support informant questionnaires; (2) Automate the administration of the questionnaires; (3) Design and automate the generation of individual patient summary reports; (4) Design and create the dynamic referral capability; (5) Establish preliminary cancer patient norms and psychometric properties for the MHADRO scales; and, (6) Evaluate end-user acceptance (medical, mental health, patient, support informant). During Phase II, monitoring reports indicating changes/trends in the patient's psychosocial condition over time will be automated; software will be developed to produce aggregate program level reports; ETR algorithms will be derived; predictive models for nonadherence will be developed; system implementation materials will be written; and a randomized, controlled trial will be completed to establish the MHADRO's efficacy in identifying clinically relevant mental health issues and facilitating appropriate treatment. [unreadable] [unreadable] [unreadable] [unreadable] [unreadable] [unreadable]